Surgical Treatment of Scleral Ulceration as a Complication of Pterygium Excision.

Sohn, Yong Ho; Yu, Seung Lyul; Uhm, Ki Bang

Original Article

Journal of the Korean Ophthalmological Society 1995;36(8):1323-1330.
Published online August 1, 1995.

Surgical Treatment of Scleral Ulceration as a Complication of Pterygium Excision.

Yong Ho Sohn, Seung Lyul Yu, Ki Bang Uhm

Department of Ophthalmology, College of Medicine, Hanyang University, Seoul, Korea.

익상편절제술후 발생한 공막궤양의 외과적 치료

손용호(Yong Ho Shhn),유승렬(Seung Lyul Yu),엄기방(Ki Bang Uhm)

Abstract

Mitomycin C is now being used not only as an adjunct in the surgical treatment of pterygia but also in glaucoma surgery. However, several serious complications that are possibly related to mitomycin C treatment have been reported. We report on a series of 8 patients(10 eyes) who experienced scleral ulcer after pterygium excision. The period from operation to onset of scleral ulcer was between 5 months and 20 years. Complications included corneoscleral perf oration(1 eye), scleral ulceration(9 eyes), corneal ulceration(2 eyes), complicated cataract(5 eyes) and uveitis(4 eyes). We used autogenous temporalis fascia to reinforce the weakened lesion of 10 eyes with scleral or corneoscleral ulceration. Three eyes underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation after stable grafting. Grafts remained stable in 9 eyes over a mean follow-up of 10.8 +/- 10.4 months(3 to 37 months). One graft melted but regrafting salvaged the eye. Six of 10 eyes improved vision. All patients resolved their subjective symptoms after temporalis fascia grafting. We found autogenous temporalis fascia grafting is efficacious in both treating and preventing ocular perforation due to progressively destructive scleral ulceration.

Key Words: Mitomycin C;Pterygium excision;Scleral ulcer;Temporalis fascia graft